Dinis-Ribeiro Mário, Lomba-Viana Helena, Silva Rui, Moreira-Dias Luís, Lomba-Viana Rafael
Department of Gastroenterology, Instituto Português de Oncologia, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
J Clin Gastroenterol. 2002 May-Jun;34(5):533-5. doi: 10.1097/00004836-200205000-00010.
To determine the prevalence of associated primary tumors in patients with gastric cancer.
Retrospective study of 2,668 patients with gastric cancer observed at our department between July 1974 and December 1999. Associated tumors were diagnosed using Warren and Gates criteria, and included tumors that were not considered to be a metastasis, invasion, or recurrence of gastric cancer.
Of all, 3.4% (n = 78) had primary tumors other than gastric cancer, 27% of which were synchronous (n = 21) and 73%, metachronous (n = 57). The mean follow-up time was 4 years (range, 1-13 years), and the male-to-female ratio was 1:1. The median age at diagnosis of gastric cancer was 67 years (range, 37-84 years), 69 years for patients with synchronous tumors versus 60 years for those with metachronous (p = 0.050). For at least half the patients the median time interval to metachronous cancer was 3 years (range, 1-22 years). Seventy-eight percent (n = 61) had two cancers; most were colonic (19%), uterine and ovarian (16%), and breast tumors (13%). Seventeen percent (n = 13) had three tumors: colon (46%), breast (23%), and skin (23%). Four percent (n = 3) had four tumors. One case with seven tumors was also observed [colon, breast (two tumors), uterus, skin, and stomach (two tumors)]. No statistically significant differences were found between synchronous and metachronous with regard to sex, gastric cancer location, and staging (TNM). Sixty-three percent (n = 49) died while under observation.
We found associated tumors in 3.4% of patients with gastric cancer. The most frequent associated tumors were breast and colon cancer. Surveillance for these tumors would be appropriate, at least in first years, after diagnosis of gastric cancer.
确定胃癌患者中相关原发性肿瘤的患病率。
对1974年7月至1999年12月间在我科观察的2668例胃癌患者进行回顾性研究。采用沃伦和盖茨标准诊断相关肿瘤，包括那些不被认为是胃癌转移、侵犯或复发的肿瘤。
总共3.4%（n = 78）的患者除胃癌外还有原发性肿瘤，其中27%为同时性肿瘤（n = 21），73%为异时性肿瘤（n = 57）。平均随访时间为4年（范围1 - 13年），男女比例为1:1。胃癌诊断时的中位年龄为67岁（范围37 - 84岁），同时性肿瘤患者为69岁，异时性肿瘤患者为60岁（p = 0.050）。至少一半患者发生异时性癌症的中位时间间隔为3年（范围1 - 22年）。78%（n = 61）的患者有两种癌症；大多数是结肠癌（19%）、子宫和卵巢癌（16%）以及乳腺癌（13%）。17%（n = 13）的患者有三种肿瘤：结肠癌（46%）、乳腺癌（23%）和皮肤癌（23%）。4%（n = 3）的患者有四种肿瘤。还观察到1例有七种肿瘤的病例[结肠癌、乳腺癌（两种肿瘤）、子宫癌、皮肤癌和胃癌（两种肿瘤）]。在性别、胃癌位置和分期（TNM）方面，同时性和异时性肿瘤之间未发现统计学上的显著差异。63%（n = 49）的患者在观察期间死亡。
我们在3.4%的胃癌患者中发现了相关肿瘤。最常见的相关肿瘤是乳腺癌和结肠癌。至少在胃癌诊断后的头几年，对这些肿瘤进行监测是合适的。
